Application for Temporary Protected Status

OMB No. 1615-0043; Exp. 07/31/07

Instructions for I-821, Application for
Temporary Protected Status

Department of Homeland Security
U.S. Citizenship and Immigration Services

Instructions
Please read these instructions carefully to properly complete this form. If you need more space to complete an answer, use a
separate sheet(s) of paper. Write your name and Alien Registration Number (A #), if any, at the top of each sheet of paper
and indicate the section and number of the item to which the answer refers.

What Is the Purpose of This Form.
To apply for a temporary immigration status granted to
eligible nationals of designated countries.

Who May File This I-821.
You must be an eligible national of a foreign state (or parts
thereof) or an alien having no nationality who last
habitually resided in a foreign state that has been
designated for Temporary Protected Status (TPS) by the
Secretary of the Department of Homeland Security
pursuant to section 244A of the Immigration and
Nationality Act. You should check with the nearest office
of USCIS for designations currently in force or visit our
website at www.uscis.gov.

General Instructions.
Step 1. Fill out the form I-821
1. How Should You Prepare This Form?
A. Type or print legibly in black ink.
B. If you need extra space to complete any item,
attach a continuation sheet, indicate the item number
and date and sign each sheet.
C. Answer all questions fully and accurately. If any item
does not apply, please write "N/A."

Step 2. General requirements
1. Are You Also Required to File Form I-765,
Application for Employment Authorization?
Yes. Each applicant, regardless of age, must also
submit a completed Form I-765, even if employment
authorization is not being requested.
If your application for TPS is granted and you want
to travel outside the United States and return, you must
request advance parole from USCIS by filing a Form
I-131, Application for Travel Document, with the
appropriate USCIS office. A Form I-512 travel
document will be issued to you if your request is
granted.
2. What Documents Should You Submit?
You do not need to provide original documents with
this application.

You must give USCIS copies of documents to prove you
are a national of the country designated for TPS, your
date of entry into the United States, and your U.S.
residence. In addition:
A. In certain circumstances, USCIS may ask you to submit
original documents.
B. Copies of documents in a foreign language must be
accompanied by an English translation. The translator
must certify that the translation is accurate and that he or
she is competent to translate the foreign language into
English.
C. In certain circumstances, USCIS may ask you to submit
original documents.
D. Copies of documents in a foreign language must be
accompanied by an English translation. The translator
must certify that the translation is accurate and that he or
she is competent to translate the foreign language into
English.
E. Documentation exception: If you are filing this
application for annual registration, re-registration, or
renewal of temporary treatment benefits (Parts 1 and
2 on Form I-821), you do not have to submit any
copies of documentation. You may, however, be
asked for additional information and/or documentation
in certain circumstances.
3. What Documents Do You Need
to Prove Identity and Nationality?
Submit any of the following:
A. Passport;
B. Birth certificate accompanied by photo identification;
or
C. Any national identity document from your country of
origin bearing your photo and/or fingerprint.
4. What Documents Do You Need to Prove
Date of Entry Into the United States?
Submit any of the following documents:
A. Passport;
B. I-94 Arrival/Departure Record; or
C. Copies of documents specified in item Number 5
below.
Form I-821 Instructions (Rev. 07/30/07) N

5. What Documents Do You Need to Prove
Residence in the United States?

6. What If Documents Are Not Available?
If documents are not available, you may give USCIS an
affidavit showing proof of unsuccessful efforts to obtain
the documents, explaining why the consular process is
unavailable (for identity documents), and affirming that
you are a national of the designated state. (USCIS may
require a statement from the appropriate issuing
authority, certifying that the document is not available.)
Affidavits may also be used to help prove your date of
entry into the United States and residence in the United
States.

Submit any relevant documents such as:
A. Employment records (e.g., pay stubs, W-2 Forms,
certification of the filing of Federal income tax
returns, state verification of the filing of state income
tax returns, letters from employer(s) or, if you are
self employed, letters from banks and other firms
with whom you have done business.
NOTE: In all of these documents, your name and the
name of the employer or other interested organization
must appear on the form or letter, as well as relevant
dates. Letters from employers must be in affidavit
form and shall be signed and attested to by the
employer under penalty of perjury.
Such letters must include: (1) your address(es) at the
time of employment; (2) exact period(s) of
employment; (3) period(s) of layoff; (4) duties with the
company. If the employment records are unavailable,
submit an affidavit form-letter explaining why these
records cannot be obtained. This affidavit form-letter
shall be signed and attested to by the employer under
penalty of perjury.
B. Rent receipts, utility bills (gas, electric, phone, etc.),
receipts, or letters from companies showing the dates
during which you received service.
C. School records (letters, report cards, etc.) from the
schools that you or your children have attended in
the United States, showing the name(s) of the
schools and periods of school attendance.
D. Hospital or medical records concerning treatment or
hospitalization of you or your children, showing the
name of the medical facility or physician and the
date(s) of the treatment or hospitalization.
E. Attestations by churches, unions or other organizations
to your residence identifying you by name. The
attestation must be signed by an official (whose title is
shown); show inclusive dates of membership; state the
address where you resided during membership
period(s); include the seal of the organization impressed
on the letter or the letterhead of the organization, if the
organization has letterhead stationery; establish how the
author knows you; and establish the origin of the
information being attested to.
F. Additional documents may include money order
receipts for money sent in or out of the country;
passport entries; birth certificates of children born in
the United States; dated bank transactions;
correspondence between you and another person or
organization; U.S. Social Security card; Selective
Service card; automobile license receipts, title, vehicle
registration, etc.; deeds, mortgages, contracts to which
you have been a party; tax receipts; insurance policies;
receipts; letters; or

A.

Except as noted below, all applicants for initial
registration, re-registration or renewal of temporary
treatment benefits will have a full set of biometrics
(fingerprints, photograph, and a signature) collected at
an Application Support Center (ASC), and must submit
the $80.00 biometrics services fee

B.

TPS applicants under 14 years of age who are not filing
for an EAD are exempt from biometrics collection and
the associated biometrics fee.

C.

USCIS may, in its discretion, waive the collection
of certain biometrics such as fingerprints and signatures.

Where To File.
The USCIS office having jurisdiction over your place of
residence will accept this application, either in person or
through the mail, or both. For filing instructions, please
inquire by calling the USCIS National Customer Service
Center at 1-800-375-5283.

Photographs.
A.

If you are filing for a reentry permit or a refugee
travel document, or if you are in the United States
and filing for an advance parole document:
You must submit two identical color photographs of
yourself taken within 30 days of the filing of this
application. The photos must have a white to off-white
background, be printed on thin paper with a glossy
finish, and be unmounted and unretouched.
Passport-style photos must be 2" x 2." The photos must
be in color with full face, frontal view on a white to offwhite background. Head height should measure 1" to 1
3/8" from top of hair to bottom of chin, and eye height
is between 1 1/8" to 1 3/8" from bottom of photo. Your
head must be bare unless you are wearing a headdress as
required by a religious order of which you are a
member. Using pencil or felt pen, lightly print your
name and Alien Receipt Number on the back of the
photo.

Form I-821 Instructions (Rev. 07/30/07) N Page 2

What Is the Filing Fee.
1. An initial (i.e., first-time) applicant must submit:
A. A $50.00 application fee for the Form I-821; and
B. A $80.00 fee for biometric services, including
fingerprints, photograph and signature, if required.
(See No. 7, Will TPS Applicants Need to Provide
Fingerprints and Photographs?); and
C. A $340.00 fee for the Form I-765, Application for
Employment Authorization, if you are between the
ages of 14 and 64 years and seeking employment.
2. An applicant for TPS re-registration or renewal of
temporary treatment benefits must submit:
A. A $80.00 fee for biometric services, including
fingerprints, photograph and signature, if required.
and
B. A $340.00 fee for the Form I-765, Application for
Employment Authorization, if you wish to apply for
employment authorization.
The check or money order must be drawn on a bank or
other financial institution located in the United States and
must be payable in U.S. currency; and
Make the check or money order payable to U.S. Department
of Homeland Security, unless:
A. If you live in Guam and are filing your petition
there, make it payable to Treasurer, Guam.
B. If you live in the U.S. Virgin Islands and are filing
your petition there, make it payable to
Commissioner of Finance of the Virgin Islands.
NOTE: Please spell out U.S. Department of Homeland
Security; do not use the initials "USDHS" or "DHS."
Notice to Those Making Payment by Check. If you send us
a check, it will be converted into an electronic funds transfer
(EFT). This means we will copy your check and use the
account information on it to electronically debit your account
for the amount of the check. The debit from your account will
usually take 24 hours, and will be shown on your regular
account statement.
You will not receive your original check back. We will
destroy your original check, but we will keep a copy of it. If
the EFT cannot be processed for technical reasons, you
authorize us to process the copy in place of your original
check. If the EFT cannot be completed because of insufficient
funds, we may try to make the transfer up to two times.

How to Check If the Fees Are Correct.
The form and biometric fees on this form are current as of
the edition date appearing in the lower right corner of this
page. However, because USCIS fees change periodically,
you can verify if the fees are correct by following one of the
steps below:
1. Visit our website at www.uscis.gov, select
"Immigration Forms" and check the appropriate fee;
2. Review the Fee Schedule included in your form
package, if you called us to request the form or
3. Telephone our National Customer Service Center at
1-800-375-5283 and ask for the fee information.
NOTE: If your Form I-821 requires payment of a biometric
service fee for USCIS to take your fingerprints, photograph
and/or signature, you can use the same procedure to obtain
the correct biometric fee.
Are You Also Required to File Form I-765,
Application for Employment Authorization?
Yes. Each applicant, regardless of age, must also
submit a completed Form I-765, even if employment
authorization is not being requested.
If your application for TPS is granted and you want
to travel outside the United States and return, you must
request advance parole from USCIS by filing a Form
I-131, Application for Travel Document, with the
appropriate USCIS office. A Form I-512 travel
document will be issued to you if your request is
granted.

Address Changes.
If you change your address and you have an application or
petition pending with USCIS, you may change your address
on-line at www.uscis.gov, click on "Change your address with
USCIS" and follow the prompts or by completing and mailing
Form AR-11, Alien's Change of Address Card, to:
U.S. Citizenship and Immigration Services
Change of Address
P.O. Box 7134
London, KY 40742-7134
For commercial overnight or fast freight services only, mail
to:
U.S. Citizenship and Immigration Services
Change of Address
1084-I South Laurel Road
London, KY 40744
Form I-821 Instructions (Rev. 07/30/07) N Page 3

Processing Information.
Any Form I-821 that is not signed or accompanied by the
correct fee, will be rejected with a notice that the Form
I-821 is deficient. You may correct the deficiency and
resubmit the Form I-821. An application or petition is not
considered properly filed until accepted by USCIS.
Initial processing. Once a Form I-821 has been accepted, it
will be checked for completness, including submission of the
required initial evidence. If you do not completely fill out the
form, or file it without required initial evidence, you will not
establish a basis for eligibility and we may deny your Form
I-821.
Requests for more information or interview. We may
request more information or evidence, or we may request that
you appear at a USCIS office for an interview. We may also
request that you submit the originals of any copy. We will
return these originals when they are no longer required.
Decision. The decision on a Form I-821 involves a
determination of whether you have established eligiblity for
the requested benefit. You will be notified of the decision in
writing.

USCIS Forms and Information.
To order USCIS forms, call our toll-free number at
1-800-870-3676. You can also get USCIS forms and
information on immigration laws, regulations and procedures
by telephoning our National Customer Service Center at
1-800-375-5283 or visiting our internet website at www.uscis.
gov.

Privacy Act Notice.
We ask for the information on this form, and associated
evidence, to determine if you have established eligibility for
the immigration benefit for which you are filing. Our legal
right to ask for this information can be found in the
Immigration and Nationality Act, as amended. We may
provide this information to other government agencies. Failure
to provide this information, and any requested evidence, may
delay a final decision or result in denial of your Form I-821.

Paperwork Reduction Act.
An agency may not conduct or sponsor an information
collection and a person is not required to respond to a
collection of information unless it displays a currently valid
OMB control number. The public reporting burden for this
collection of information is estimated at 1 hour and 30 minutes
per response, including the time for reviewing instructions,
completing and submitting the form. Send comments
regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing
this burden, to: U.S. Citizenship and Immigration Services,
Regulatory Management Division, 111 Massachusetts
Avenue, N.W., 3rd Floor, Suite 3008, Washington, DC 20529.
OMB No. 1615-0043. Do not mail your application to this
address.

As an altenative to waiting in line for assistance at your local
USCIS office, you can now schedule an appointment through
our internet-based system, InfoPass. To access the system,
visit our website. Use the InfoPass appointment scheduler and
follow the screen prompts to set up your appointment.
InfoPass generates an electronic appointment notice that
appears on the screen.

Penalties.
If you knowingly and willfully falsify or conceal a material
fact or submit a false document with this Form I-821, we will
deny the Form I-821 and may deny any other immigration
benefit.
In addition, you will face severe penalties provided by law and
may be subject to criminal prosecution.

Form I-821 Instructions (Rev. 07/30/07) N Page 4